Opinion: John Ryall – Looking Beyond the Obvious for Health Gains

The new Labour-led Government is committed to restoring the $2 billion-plus that they say the previous government took out of our public health system in its nine years in office. But, are we looking in the right place when it comes to investment in better health for New Zealanders?

November 15, 2017

The new Labour-led Government is committed to restoring the $2 billion-plus that they say the previous government took out of our public health system in its nine years in office. But, are we looking in the right place when it comes to investment in better health for New Zealanders?

During the General Election campaign Labour leader, Jacinda Ardern announced a new scheme where the new Government would fund Very Low-Cost Access GP practices where adult patients would only pay $8 a GP visit; $2 per visit for those aged 13-18 years old, and no charge for children under 13.

These new maximum charges would also be extended to people with a community service card, who are with a non-VLCA practice but whose GP opts into the scheme. In addition to these changes all other patients would enjoy a $10 reduction in their GP charges.

There are also commitments to free mental health services; the re-establishing of the Mental Health Commission; pay equity for community mental health support workers, and extra funding for youth mental health counselling services.

While the health agenda is a bold one, NZ First Leader, Winston Peters did not mention health directly when he announced he was joining the Labour-led Government.

He said that “capitalism” (take that to read “neo-liberal capitalism”) was failing New Zealanders and it was time to reshape capitalism with a human face.

What Winston was referring to is the clear divide in New Zealand between the haves and the have-nots, between those who feel good about where they are at and those who feel that the “system” is not working for them.

There is no better example of this than Fonterra CEO, Theo Spierings, with his $8 million plus annual salary package, whilst Fonterra’s contract cleaners, catering assistants and security guards earn just over $16.00 an hour.

We have known for a very long time that income inequality is a major factor in poor health outcomes. New Zealand researchers have gone some outstanding work in this area and in 2011 the NZ Medical Association, in its paper on health equity, reinforced this point.

Even with access to high quality health care, people’s income is a key factor in determining how healthy people are. There is a strong correlation between low income and a long list of health issues, including shortened life expectancy and poorer self-reported health status.

Low pay puts stress on workers and their families because of the need to work incredibly long hours to make ends meet, as well as a lack of adequate sick leave. The many people now in insecure work also face an increased risk of elevated and on-going stress and exhaustion, cardio-vascular disease, a lower life expectancy, and obesity.

The new Labour-led Government is targeting low pay as a health investment, on par with its planned investment in housing, tertiary education fees, public transport and cleaning up our rivers.

Already, the new Government has announced a big lift in the minimum wage. Also, within its first 100 days it will increase paid parental leave to 26 weeks and introduce legislation to give workers more power in their workplaces to negotiate with their employer for higher wages.

The Government will also consult with employer and union representatives about the implementation of a system of Fair Pay Agreements, where negotiations, regulated by the Employment Relations Authority, can get underway to set minimum pay rates, hours of work, overtime and leave arrangements, across industries where the reliance on the market has led to a race to the bottom for workers’ employment conditions.

In addition to these measures the new Government is committed to implementing the Living Wage for all core public sector workers and to extend this to workers employed by contractors to the core public sector, such as parliamentary cleaners and WINZ security guards.

Each and every one of these changes will be opposed by those who received the benefits of the current system. But this huge investment in housing, education, public transport and a liveable wage is probably a far better long-term investment in improving health outcomes for most New Zealanders than building more hospitals to care for the growing numbers of poor people who need medical treatment.

John Ryall is assistant national secretary of E tū, the union that initiated the Bartlett v Terranova case that ultimately lead to the pay equity settlement for 55,000 care and support workers.

Liz Wylie talks to a Whanganui woman who has been on the inside of acute mental health support services and gets a professional view on where the new Government's promised health spending might benefit the community.